Screening for congenital hypothyroidism--a new era in Bangladesh.

Neonatal screening is a new concept in Bangladesh. Currently a pilot program is ongoing where newborns are screened for congenital hypothyroidism (CH). In a country like Bangladesh, where people are still fighting childhood problems like malnutrition, diarrhea and other communicable diseases with a high infant and child mortality rate, instituting a newborn screening program is a challenge. TSH is measured on filter paper using IRMA methods. Both cord and heel prick blood are used. A cut off value of 20 mIU/l is used above which all babies are recalled for serum T4 evaluation. Approximately 2600 newborns have been screened in the pilot program. Of these, 2 newborns were detected with CH (incidence rate 1:1300). Since it is a new program in Bangladesh, effort is mainly given on popularizing the program and building necessary infra-structure. The newborn screening program has been accepted with mixed reaction in the community. Hopefully, the government is developing a positive attitude towards the program. The paediatricians and obstetricians are also interested. The program needs more publicity. Patronization by the government and other international bodies will be essential for continuation of the program.